前臂游离皮瓣功能性修复颌面部缺损的临床体会

目的：探讨个体化设计前臂皮瓣修复领面部缺损，以期达到恢复其解剖形态和生理功能的目的。方法：选择舌癌、颊癌、口底癌患者20例，设计前臂皮瓣时，一是根据缺损大小、形状设计其皮肤外形，二是根据桡动脉和头静脉走行，设计皮下筋膜层外形，包括桡动脉和头静脉在内，大于皮肤范围。术后半个月、3个月、6个月评价修复器官的解剖形态、黏膜化程度、发音清晰度、运动及饮食类型等诸方面生理功能。结果：20例皮瓣全部获得成功，术后半个月和3个月有不同程度的皮瓣外形臃肿，6个月后．修复器官解剖形态无臃肿和牵拉，发音较清晰，感觉功能也有不同程度的恢复，大部分患者（18／20）进普食，少部分（2／20）为软食。结论：皮肤和筋膜下设计前臂皮瓣修复颌面部缺损，可以较好恢复颌面部器官的解剖形态和生理功能。

Clinical experience of functional reconstruction of maxillofacial defects with free forearm flap

PURPOSE:To study the individual design of free forearm flap for maxillofacial defects to restore their anatomical shape and physiological function.METHODS:Twenty cases of oral cancers in tongue,buccal and floor of mouth were selected.The design of the forearm flap followed the following principles,the shape of the skin was determined by the size and shape of the defect.The subcutaneous fascia shape was designed according to the radial artery and cephalic vein course.The scope included the radial artery and ...